Abstract
Objectives:
In the medical literature regarding injuries of the ulnar collateral ligament (UCL), baseball players comprise a majority of the athletes studied. Baseball players endure repetitive valgus forces in the elbow that can cause damage to the UCL with the overhead throwing motion. However, there are limited studies in the literature regarding UCL injuries in non-baseball throwing athletes, specifically in softball, football, and javelin throwing. We performed a retrospective analysis of patients treated surgically for UCL injuries at our institution between April 2010 and July 2019. Our hypothesis was that there would be a high success rate of recovery among non-baseball throwing athletes with UCL injuries.
Methods:
Inclusion criteria for this study included patient who underwent either the surgical repair or reconstruction of the UCL in non-baseball throwing athletes with at least two-year follow-up. We excluded patients that had missing operative reports and any patients that participated in baseball. We retrospectively identified all patients eligible for the study and contacted them by phone to give informed consent and achieve follow-up data. For data collection, we used the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the Kerlan-Jobe Orthopaedics Clinic Shoulder and Elbow Score (KJOC), and our institution-specific Return to Play questionnaire.
Results:
After we applied the exclusion and inclusion criteria to our elbow database search, we identified 66 patients eligible for the study. Of the 66 patients, 34 patients had missing or incomplete operative reports, leaving 32 patients. Of the 32 patients, 26 patients (81%) were successfully contacted and followed up with. Of these 26 patients, 14 (54%) underwent UCL repair, whereas 12 (46%) underwent UCL reconstruction. The average age of participants at the time of surgery was 19.1, and the average post-operative time at follow-up was 4.68 years.
Two patients had subsequent revision UCL procedures (6.3% failure rate). The surgical satisfaction in the 26 patients was an average of 9.67 out of 10. The average Andrews/Carson score was 92.5, and the average KJOC score was 90.6. Additionally, out of the 26 patients evaluated who played sports at the time of their arthroscopy, two had ceased athletic participation due to limitations of the elbow.
Conclusions:
In conclusion, we identified excellent clinical outcomes following UCL procedures in non-baseball throwing athletes with a 92% return to play rate and high surgical satisfaction and functional outcome scores. Further statistical analysis is needed for additional comparisons, including return-to-play between different sports, and outcome comparisons between different surgical techniques performed. However, this study significantly adds to the previously scarce literature on clinical outcomes following surgical treatment for UCL injuries in non-baseball throwing athletes.